A Student's View: Republicans unveil new health care plan

Friday

Mar 17, 2017 at 3:26 PM

By Ryan Henderson

Editor’s note: Ryan Henderson is a senior at Maynard High School. For his Senior Project he is researching the Patient Protection and Affordable Care Act. Senior Project is a capstone course allowing students to pursue research and an internship in a field of interest. For the project portion of the class he is updating congressional and administrative changes to the ACA. In the coming weeks he will examine the ACA and the impact of its repeal.

Earlier this month, House Republicans released the first draft of their legislation to repeal and replace the Affordable Care Act. The bill, officially named the American Health Care Act, began on a rough patch as Democrats and far-right Republicans started to criticize it. Despite the infighting as well as the opposition from across the aisle, Speaker of the House Paul Ryan insists that Republicans will end up being united on this bill. To be sure, it is only a draft bill, and not official legislation, so it could very well be subject to change and improvement.

The idea behind the bill is to move healthcare away from the federal government, and to give it back to the people and individual states.

Some major points of the AHCA include:

● Repeal the fine on those that do not purchase health insurance.

● People would get tax credits based on age instead of income-based premium subsidies; the subsidies would then phase out for higher-earning people.

● The law would keep the popular Affordable Care Act mandates of keeping children 26 years old and under on their parents' health care, as well as the mandate of people being covered for pre-existing conditions.

● Obama’s expansion of Medicaid to include more lower-income citizens would continue until 2020; after that the bill would eventually change how the government funds Medicaid.

● The law would repeal a series of taxes on higher earners and insurance companies that was used to pay for the coverage expansion of the ACA.

● Through this bill, Republicans would overhaul the federal-state financing, changing it from open-ended federal financing to a limit based on enrollment and costs unique to each state.

● Greatly expands contributions to health savings accounts, which allow people with high-deductible insurance to cover expenses that their plans don’t pay for.

● Imposes a one-year funding freeze on Planned Parenthood.

Again, many Republicans have openly come out against this draft bill, arguing it is just a variation of the ACA, and not the full “repeal and replace” that Republican leadership promised to their voters. Sen. Rand Paul of Kentucky is one such Republican, who has been criticizing the bill, calling it "Obamacare lite" and claiming that conservatives will hold their vote on the bill in its current form. Even with strong enough resistance, the bill has already cleared two House committees this week: the Ways and Means, and the Energy and Commerce. The bill will likely come to the floor of the House by the end of the month.

The bill has received an endorsement from President Donald Trump, who recently proclaimed it as “wonderful” over Twitter. Trump also expressed a willingness to negotiate and make deals with critics of the piece of legislation. True to his word, he had a few leaders of the far-right group, the Freedom Caucus, in for a discussion, a group that has expressed ill sentiments towards the bill. The grievances that these lawmakers have with the bill is that the system of tax credits it creates allows a new government entitlement, also that it does not do enough to curb the ACA’s Medicaid expansion, and that it mostly leaves the ACA’s insurance coverage mandates in place. Opposite Trump however, Speaker Paul Ryan has come out and put a large emphasis on the delicate nature of the bill and that the bill is not up for major changes. He made his case to fellow Republican legislators and the American public during a news conference Thursday night over cable news. Ryan claimed that Republicans face a “binary choice”: to either vote through the AHCA, or let the ACA survive.

It will be interesting to see whether or not Ryan will be able to whip his voting caucus to the 218 votes needed to pass the bill onto the Senate. Maybe Ryan will buckle to far-right wingers of the House and end up making significant changes to the bill. Also, in the Senate it is questionable as to whether the bill would pass in its current form, as Republicans only hold a two-seat edge, and Se.Rand Paul had already come out and denounced the bill.

This is all setting the stage for likely the largest legislative battle to be fought in Congress this year.